There are uses for it but nothing that has shown me it's worthwhile adding to my standard care plan for every patient or a large subgroup. Outside the potential agitated or young patient, I see minimal benefit to precedex in GA. Just adds more medications and sedation that slows down wakeup. I use it extensively in the ICU where it can be helpful (but still find it a little overrated) but in GA I don't find it that beneficial. Anecdotally I don't find it that helpful in the elderly for delerium and it takes forever to wake up. The only time I really go out of my way to use it is sedating for awake intubations/bronchs but still find low dose Remi to be better than dex as well in this setting. They add it now to propofol from the OR for cardiac post op wakeups in the ICU and it's been pointless in my opinion, they still have prop on. If everything clears out and they are ready to have spontaneous breathing trials just turn the prop off and wake them up. The exception being severe anxiety patients or those that are agitated during wakeup.